Too many parents approach issues in their adult child’s life with the unspoken rejoinder, close your mouth and open your wallet. Parents often give no advice, even when they have serious concerns. Thirty years as a family therapist and 28 years as a father, have taught me that parents should voice their opinion to their adult child about two specific issues: getting married and not waiting numerous years before having children.

The Domino EffectIn recent years, the trend of delaying marriage has caused a domino effect on other trends which have a significant emotional cost for families and an enormous financial cost to society. The dominos are: delayed marriage—delayed childbearing—augmented infertility—elevated multiple births—increased rates of pre-term births and caesarian sections. My goal in this column is to describe these decisions to delay marriage and childbearing and the resulting consequences. I will offer some suggestions that parents might use in dealing with their adult child.

Of the 4.1 million births registered in the U.S. in 2005, 37 percent were born to unmarried women (CDC). Some of the reasons that couples cohabit include: convenience, economy of savings, preparation for the marriage commitment, and apprehension about the high divorce rate. But these couples are actually practicing non-commitment. Even if they eventually marry, they have less satisfying marriages and higher divorce rates than spouses who did not first live together (National Marriage Project). If the unmarried biological parents go their separate ways, where does that leave the children?

If I am perhaps describing your adult child, don’t you want the best possible family environment for your grandchild? Wouldn’t you consider voicing your opinion to your son or daughter, knowing the irrefutable research finding: the best environment to raise children is two biological parents in a low-conflict marriage? You might respond that you don’t want to “meddle” or times have changed and it’s not like the old days when parents spoke their minds. My response mirrors a recent mass e-mail: don’t be so open-minded that your brains fall out.

Adult Children Do ListenPlease don’t misunderstand me: Parents should not tell their grown child everything on their minds. But, in matters that are crucial for their well-being, they must speak up. My three decades of research into family size decisions have shown that adult children are aware of and appreciably influenced by the attitudes of their parents. One of my own survey research findings is the importance of family-of-origin family size as a predictor of total family size. The decisions our parents made about family size tend to have a significant impact on our own decisions.

In fact, reliance on the advice of parents has been described in the National Survey of Student Engagement (2007) which questioned 313,000 randomly selected college students. The survey revealed that young adults follow the advice of both parents more than twice as much as they listen to friends. So, if your son or daughter informs you that he/she wants to live together with a “significant other” for a few years, possibly even have a child or two, don’t respond with that 1960’s expression, do your own thing.

The First Two DominosCouples, who do choose to marry, are waiting longer to do so. According to the Census Bureau, between 1970 and 2000, the median age at first marriage for women increased by 4.3 years to 25.1 years; for men the increase was 3.6 years to 26.8.

In tandem with the later age at first marriage, is the decision to delay childbearing. The mean age of mothers in the U.S. was 24.6 in 1970 which increased to 27.2 in 2000 (CDC). Approximately 20% of women wait until after 35 to begin having children (www.ASRM.org). Consider that birth rates for women 35-39 and 40-44 years (which have risen steadily in recent years) each increased 2% in just one year, 2005 (CDC).

Why do these delays occur? Education and career, which are positive trends, are important factors in women’s decisions to delay marriage and motherhood. From 1970 to 2000, the percent of women having completed four or more years of college nearly tripled and the female labor force participation rate increased by 39% (CDC 12/11/02). The availability of contraception allows couples to delay childbearing while strengthening their relationship, establishing careers, and amassing enough assets to settle down for a secure and comfortable future. But how emotionally secure and financially comfortable are they going to be down the road? Will their marital bond be able to withstand the stress imposed by infertility, multiple births, and pre-term infants?

InfertilityThe decision to delay comes with consequences that take their toll on spouses and society. The miscarriage rate (34%) is triple for women 40-44, compared to those ages 20-29 (10%). The risk of having a Down Syndrome child increases from one in 1250 for a 25 year old mother, to one in 30 for a 45-year-old mother (ASRM). Infertility, the next domino, affects 7.3 million people in the U.S., representing 12% of the women in the reproductive age population (CDC). A healthy 30 year old woman has a 20% chance each month to get pregnant; a healthy 40 year old woman has a 5% chance each month (ASRM). Secondary infertility, which can follow the birth of one or more biological children, is more prevalent than primary infertility. The emotional toll from the long-term inability to conceive a child can be devastating to spouses. Common feelings include: frustration, jealousy, anger, isolation, sadness and guilt. Self-image and self-confidence are affected as well.

Frequent visits to physicians interfere with careers and regardless of which spouse has the physical problems, most of the tests and treatments focus on the woman’s body. People typically assume that infertility is the woman’s fault and that adds to the stress (Abby, Andrews and Halman. Journal of Marriage and Family, May 1992). The financing of infertility treatments is considerable. Each in vitro fertilization cycle costs more than $12,000 with many couples requiring multiple cycles. The total cost for all types of fertility treatments exceeds $3 billion per year.

Remember when your child was young; you didn’t want to spoil her by giving her everything she asked for at the mall. But you knew which gift she really wanted and you waited for the right occasion to give it. Now, imagine your feelings of helplessness, when your adult child wants nothing in this world more than to parent a child. You can be supportive and optimistic, but there is no department store that sells what you wish you could buy.

Multiple BirthsThe huge number of couples undergoing fertility treatments has tipped another domino, multiple births. About 45% of Assisted Reproduction Techniques pregnancies result in twins and 7% in triplets or more (March of Dimes). The birth rate for twins in the U.S. rose steadily between 1990 and 2004, climbing an average of 3% annually for a total increase of 42% since 1990, and 70% since 1980. “Two related trends have been closely associated with the rise in multiple births over the last two decades: the older age at childbearing (women in their thirties are more likely than younger women to conceive multiples spontaneously) and the widening use of fertility therapies” (CDC 12/5/07).

Increased fetal risks include: higher chance of miscarriage, birth defects, and the mental/physical problems that can result from a premature delivery. Fetal mortality rates are higher for a number of groups, including: women who are 35 and over, unmarried women, and multiple deliveries. “Twins are 5 times and triplets are nearly 15 times more likely than singletons to die within a month of birth” (CDC 12/5/07). Maternal risks include high blood pressure, diabetes, and hemorrhaging”. Multiple gestation is associated with more depression, lack of sleep, financial difficulties, and marital discord (ASRM).

One method of reducing the risks is Multi-fetal Pregnancy Reduction. When there are four or more fetuses present, the number is reduced to one or two. This technique is used in an effort to increase the likelihood that the pregnancy will continue.

Remember when you taught your child decision-making, such as which friends she could invite for a sleepover or how she should spend her hard earned allowance. Did you imagine that one day you might be giving support to your child in her decision to proceed with multi-fetal pregnancy reduction?

Pre-Term BabiesMore than half of twins are born pre-term and approximately half of twins and almost all higher order multiples start life with a low birth weight. Data from 2005 indicates the premature birth rate is continuing to rise, with more than 525,000 babies or 12.7% born prematurely (March of Dimes 12/5/07).

Preemies tend to encounter these difficulties: low birth weight, breathing problems, underdeveloped organs, risk of infection and risk of cerebral palsy (NICHD). Researchers, writing in the New England Journal of Medicine (1/17/02) concluded, “Very low birth weight participants had a lower mean IQ; educational disadvantage associated with very low birth weight persists into early adulthood.” And the emotional toll? Preemie families face a stressful new world. Parents may only enjoy a brief encounter with their baby before she is whisked away to the NICU for weeks, even months. And the financial toll? More than $26.2 billion per year. “Direct health care costs to employers for a premature baby average $41,610—15 times higher than the $2,830 for a healthy, full-term delivery. Additional costs to employers in lost productivity average $2,766” (March of Dimes, Cost to Business).

Remember when you taught your child patience, such as waiting for a mail-order gift to arrive or standing in line at Disney World. Now, imagine how you may need to give strength to your child as she waits patiently for her baby to come home after months in the NICU.

Caesarian SectionsThe last domino is the soaring number of caesarian deliveries (1.25 million per year). The current c-section rate of 30.3 percent is triple the 10.4% c-section rate of 1975 (ACOG Stats and Facts 2007). Mothers of multiples are more likely to have c-sections and a growing number of doctors and patients are scheduling c-sections for their own convenience. The cost of a c-section ($13,441) is twice that of a vaginal delivery, with the national total exceeding $17 billion per year (ACOG). And the human price tag? Risks for mothers include: anesthesia, increased bleeding, chance of infection and blood clots in legs, pelvic organs, and lungs. Risks for the baby are inactivity from the anesthesia and possible breathing problems (March of Dimes).

ConclusionThe trends described above are not small blips on the radar screen; they are continents. They are years in the making and would take a major upheaval to reverse by even a percent or two. My real hope is that these trends will not continue to increase. I also hope that with the catastrophic divorce rate in the U.S. hovering at 50%, not one more marriage will succumb to the marital stress caused by these trends. But as long as parents are either too shy or too worried to put in their two cents, these emotionally devastating and costly trends may continue to surge.Remember how it took courage to sit down with your pre-teen and explain the birds and the bees? Summon that courage again and tell your adult children your opinions on the importance of marriage and the timing of children.

Remember when your child was in grade school? You soccer moms and side-line dads, who ran yourselves ragged in your minivans because violin, astronomy, chess, swimming and painting weren’t enough—you also insisted that your child go to Math camp. Didn’t you believe that all the hyper-parenting was in your child’s best interest so that she would have the best chance to succeed in life? Do you want to see your adult child go through the frustration, pain and sometimes grief from the trends described above? And the possible negative consequences for your grandchild?

Final ThoughtsIt is vital to remember the "context" that a parent would have this discussion with an adult child. You cannot just spring this topic on your grown child out of nowhere. You need to communicate and demonstrate the values of marriage and parenthood to tweens and teens, long before they are ready to be independent. Second, you have to convey to your grown children that you are willing to help them raise their children, to the extent that you are able. You cannot simply give lip service to the trends and consequences described here; you need to step up to the plate and offer your services and resources. Be willing to put your time, energy, and money where your mouth is, not only for the personal joy of bouncing a grandchild on your lap, but so your grandchildren can reap the benefits of significant contact hours with YOU....their grandparents. Don't you want to help your adult child start a family while you are young and have the energy and health to be helpful in addition to joyful? So please don't be cheap. Your offer to help your children financially in the early years of marriage can make all the difference in the world to a young couple who is determined to be self-sufficient. I’d like to change the rejoinder to open your mouth and open your wallet too.

When your newlyweds tell you they are in no hurry to start a family, will you be prepared to respond? Children do respect the opinions of their parents, and truly need to hear them.

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comments:

With all due respect, this is ridiculous. You have got to be kidding me.

Have you ever thought that perhaps someone's adult children don't want to have children at all, and would look upon their parent's efforts as undue meddling, at the very least? The number of children a couple has (if any) is the business of only the two people involved, and no one else.

Parents need to butt out of their children's lives. If that means they don't get any grandchildren, so be it.

Bonnie, I appreciate you taking the time to write. At no point in this column did I encourage anyone to have children. I am a proud father of 4 grown children and I do not encourage anyone to have children. A future column that I am working on, will mention "to make our parents into grandparents" among the worst reasons to have children. My point in this column, was to encourage parents to speak their minds to their adult children, when their children state that they plan to wait X number of years before starting a family in order to be financially secure etc.That's where parents should not keep their knowledge of the serious consequences of delayed childbearing to themselves.

However, I still disagree with your statement. The so-called "serious consequences of delayed childbearing" have been all over the news, after all, spread by numerous pundits including yourself. Most people are already aware of it. If people still choose to take their chances and try to have children later, the parents should keep their mouths shut. There is no reason to unload a guilt trip on your kids.

Hi Bonnie, thanks for writing again. I really appreciate airing our differences, because my primary motivation in writing this column was to increase the discussion on this topic. I don't think we need to debate how knowledgeable couples are in the consequences of delayed childbearing. You state that its all over the news, implying that most couples know; I'm not so sure. It is what it is.

Instead, let's zero in on what I believe is our real debate. You hit a sensative note for me personally, because my mother (of blessed memory) used to quip "guilt is a wasted emotion". Bonnie, if you are not a parent, I'd like you to imagine being a parent for just a moment. If your child is riding her tricycle straight into the street, wouldn't you grab her and admonish her in the strongest of terms? Would that be called "unloading a guilt trip" on her or are you looking out for her welfare? If I tell my daughter not to wait until age 37 to start a family, you seem to think that's a guilt trip; I call it....a concerned parent looking out for his adult child's welfare.

Infertility and caring for preemies have devastating consequences on individuals and wreak havoc on marriages. If one couple reads these words, starts their family earlier, and one marriage is saved, then this discussion will have been well worth it.

- Even people who might not necessarily have decided that they do not want children, may not be personally ready for children early on.

- It might be a risk to put off having children, but I do not think that it is any less a risk to jump into having children if you are not ready to have them or are not *really* sur ethat you want them - and it can take some time to come to this conclusion (or to finally decide that you are not cut out to have them). besides people who took a while to be ready to have children, or who were not sure they wanted them and took a while to come to want them, there are people who started out thinking that they did (or should) want them and took a while to realize that they did not. I don't think that badgering either sort of person into having kids would have ben a good thing.

- MANY people have parents who would not deal well with them saying that they did not want children (or that they didn't know if they do want them). Quite often the 'we don't want them YET', or 'not for a while' can actually be cover for someone who really doesn't want them, and doesn't want to handle the sort of drama and pushiness that can often result from comming out of the childfree/childless-by-choice closet.

Personally, I have never really wanted kids that much, but am rather apathetic on that angle.

But I think that it is far better to regret not having kids than it would be to have them before I was really ready and to regret having them.

Would it surprise you for me to enthusiastically agree with you? Especially when you say, "it is far better to regret not having kids than it would be to have them before I was really ready and regret having them."

My "campaign" with this column was certainly NOT to say, don't delay--have a child now. I am certainly not at all interested in convincing couples to have children. My motivation is, that when couples are interested in having a child someday and announce to their parents their list of reasons why they plan on delaying....1...5....or 10 years, that the parents are not quiet about the marriage-threatening consequences of delaying, but take a firm stand and offer to help with all resources available.

As much as I adore and respect our 4 children, I am the last guy in the world to tell a couple....you know what I think you need? A child.

Yes, with all due respect, Dr. Singer, I think this article and your published point of view is very dangerous, and stands to ruin many peoples lives if they follow your advice.

I am fully supportive of marriage, but I feel very strongly that people must both know themselves and their prospective partners before they commit to ANY lifelong commitments.

Way too many young people are in the "la la land" of blind love because they don't know themselves or their partners well enough. Once the initial excitement wears off - which it always does - they suddenly find themselves left with someone they have no interest in spending the rest of their lives with. if they don't have children, they are lucky, and can easily divorce. If they have the misfortune of having children in a relationship like this they are forced to make the horrible decision of continuing on in a relationship which they are miserable for the sake of their children, or getting a divorce and saddling their poor children with lifelong psychological trouble of their own.

Using fertility and childbearing as a reason to propose earlier marriage is ridiculous. People need to consider their lifelong happiness before they even think about having children. If this means they never do, then that is a worthwhile cost of making a wise choice.

I would very strongly argue that one of the most foolish things a person can ever do is get married before they are 30, or before they know their prospective partner for at least 3-4 years. There is still a chance that they make a poor decision, but at least it is an educated one.

Damn fertility. We don't need it. There are too many people in the world already.

Mattlach, thanks for your well thought-out comment. First, to repeat, at no point in this column did I encourage anyone to have children. I am a proud father of 4 grown children and I do not ever encourage anyone to have children.

A future column that I am working on, will mention "to make our parents into grandparents" among the worst reasons to have children. My point in this column, was to encourage parents to speak their minds to their adult children, when their children state that they plan to wait X number of years before starting a family in order to be financially secure etc.

That's where parents should not keep their knowledge of the serious consequences of delayed childbearing to themselves.

As far as your comments on marraige: I strongly agree that divorces which involve children are far more damaging to all parties than those without. But where's your data from on how long couples must know each other before marrying? My wife and I knew each other 4 years before our wedding and we're going on 32 years. I have known many couples that married after knowing each other 1 year and they are doing just fine. If you have some data, please share it.

The overpopulation argument: seriously, the US is barely at replacement fertility level (2.1 children). Are you referring to Angola where the average family has 7 children?

I appreciate your thoughts on this matter. I think it is wise to make couples think about these things - HOWEVER, I think we have to be very careful NOT to rush couples into having kids. Several people have mentioned this fact already but I don't think it can be emphasized enough. I'd be curious to know the societal costs, not to mention emotional toll on the kids, for couples who do rush into having children, for couples who are not emotionally or financially ready for them. What are the benefits to waiting, may be a better question - because I think there are several.

I'm also curious to get your thoughts on gay families or for gay couples who are wishing to have kids - I'm guessing, depending on the gender, the same issues might not apply - but I'd like to here what suggestions you have for them.

I sort of agree with this post. I do think many people aren't aware that fertility for women begins its decline at 27 and takes a big drop at 35. Not that women can't conceive at older ages but it can be harder or take longer.

But as a child of divorce, I was far more concerned about forming a strong and healthy marriage that would last for life, even if it took longer. Statistics show that the divorce rate is lower for those who marry older. Maybe marrying early worked better in years past, when divorce was not so common and there was far more societal support to stick together through thick and thin. Now without those things, it is far more important that a couple be well-matched and mature before marrying. I married at 29, and had children at 32 and 34. No infertility, but yes, two c-sections (not because of age but because of breech position). It worked out, although one reason I will probably not go for a 3rd child is because of my current age. Still, better to have two kids raised in a healthy intact family than more kids raised by a single mother, IMO. I was in no postion to make a wise choice of marriage partner in my early 20s.

Oh for heavens sake, enought with the "divorce is devastatign for children yeada yada...i come from two loving but divorced parents. My motther is not a "single parent" because my father is in my life. The most screwed up people I know come from "intact" homes that you speak of with visions of ozzie and harriet. Children become adults, remember? Just because youhave two miserable people livign under teh same roof does not mean your child will be better of than havign two llvign parents living 20 minutes apart.

On Sale Now!

Creating Your Perfect Family Size by: Dr. Alan Singer

Therapist: 38 years of experience as a Couples Therapist.80% success rate in saving marriages on the brink. Offices in Brooklyn, N.Y. and Highland Park, N.J.Specialties: marital rescue after infidelity, reviving empty nester marriages, family size decisions, and co-parenting implementerColumnist: The Home News TribuneAuthor: Creating Your Perfect Family Size: How to Make an Informed Decision About Having a Baby (Wiley 2011)

Motivated by the sad statistic that two thirds of divorcing couples don’t receive one hour of counseling, Dr. Singer has been a marriage therapist since 1980 and he counsels couples using Skype and Google+. He serves on the speakers bureau of the National Council of Young Israel, is a mental health provider for Relief Resources and is listed on the National Registry of Marriage Friendly Therapists. In addition, he serves as a recovery therapist for the Beyond Affairs Network. twitter.com/DrAlanSinger.

Married for 40 years, Dr. Singer and his wife are the parents of four grown children. He has conducted numerous broadcast and print interviews including: USA Today, Fox Morning News, MSNBC.com & Huffington Post.

His mantra: I Am The Last Person In The Room To Give Up On Your Marriage.